EP1437157A1 - Endoprothese vasculaire - Google Patents

Endoprothese vasculaire Download PDF

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Publication number
EP1437157A1
EP1437157A1 EP02785924A EP02785924A EP1437157A1 EP 1437157 A1 EP1437157 A1 EP 1437157A1 EP 02785924 A EP02785924 A EP 02785924A EP 02785924 A EP02785924 A EP 02785924A EP 1437157 A1 EP1437157 A1 EP 1437157A1
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EP
European Patent Office
Prior art keywords
stent
cells
axial direction
length
tubular body
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EP02785924A
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German (de)
English (en)
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EP1437157B1 (fr
EP1437157A4 (fr
Inventor
Ken Inst. for Frontier Medical Sciences IKEUCHI
Kouji Inst. for Frontier Medical Sciences MORI
Hiroo Inst. for Frontier Medical Sciences IWATA
Kazuaki Mitsudou
Hiroaki Kawasumi Laboratories Inc. NOMIYAMA
Yoshiharu Kawasumi Laboratories Inc. YOSHIKAWA
Masatoshi Kawasumi Laboratories Inc. Watanabe
Shuzou Kawasumi Laboratories Inc. YAMASHITA
Kazunori Kawasumi Laboratories Inc. MURAKAMI
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SB Kawasumi Laboratories Inc
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Kawasumi Laboratories Inc
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Publication of EP1437157A4 publication Critical patent/EP1437157A4/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02—Dilators made of swellable material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • A61F2002/9155—Adjacent bands being connected to each other
    • A61F2002/91575—Adjacent bands being connected to each other connected peak to trough

Definitions

  • the present invention relates to improvements in a stent used for amelioration of a stenosed portion that occurs in an organism such as a blood vessel.
  • a stent refers to a tubular medical tool that is placed in a stenosed portion or the like for dilating the stenosed portion, etc., to secure a necessary lumen region when a blood vessel or a lumen in an organism is stenosed or occluded.
  • the stent is inserted into a body with its diameter kept small, and is expanded in a stenosed portion, etc., to have a larger diameter so that the above lumen is dilated and sustained.
  • Figs. 11 and 12 Conventional stents are typically as shown in Figs. 11 and 12. However, these have had the following drawbacks. Fig 11A and Fig. 12A show stents before expansion, and Fig. 11B and Fig. 12B show the stents after expansion.
  • cells 206 constituting a ring unit 204 have a structure in which three linear portions 207 are connected in parallel and a curved portion 206A between the cells 206 is arranged so as to face a space 206B in the vicinity of cells 206 constituting another ring unit 204.
  • the above stent is excellent in proper radial sustaining force (which, in a general expression, means a force to sustain an expansion state of the stent against an external force from and through a blood vessel wall when the stent is expanded to be fixed to the vessel wall) and flexibility.
  • the stent Since, however, the stent is inserted through tortuous parts of a blood vessel, along the curves of it, during expansion or delivery, the cells 206 partly project outward to be caught by the wall of the vessle, so that the delivery has been sometimes difficult (which will be referred to as "flare phenomenon" hereinafter).
  • a stent 241 shown in Fig. 12 cells 246 which constitute a ring unit have a structure in which generally- ⁇ -shaped struts (linear bodies) 247 are connected with a connector portion 245. Therefore, the stent 241 has advantages that it has a strong radial-sustaining force and that the above generally- ⁇ -shaped struts 247 are not warped outward during expansion or insertion through a tortuous blood vessel. However, the defect with it is that it lacks flexibility. It is considered that the above problem is caused since each connector portion 245 has only one curved portion and also since the connector portion 245 is of small length.
  • the conventional stents thus have the problem that they are not well-balanced in flexibility and radial sustaining force.
  • the present inventors have made diligent studies for overcoming the above problems in order to provide a new stent having both flexibility and radial sustaining force, and have arrived at the present invention.
  • 1, 1A and 1B indicate stents
  • 4, 4A and 4B indicate ring units
  • 5, 5A and 5B indicate connector portions
  • 6, 6A and 6B indicate cells
  • 7 indicates a generally linear portion
  • 8, 8A and 8B indicate curved portions of connector portions
  • 9 indicates a connection portion
  • 11, 11A, 11B and 13B indicate generally linear portions
  • 12, 12A and 12B indicate curved portions of cells
  • 13 and 13A indicate curved line portion of cells
  • 14 and 14A indicate minor curved portions of cells
  • 15 and 15A indicate generally linear portions of cells
  • 17 indicates a generally- ⁇ -shaped cell
  • 18 indicates a generally-S-shaped connection portion
  • 19 indicates a component portion in stents A and B.
  • Fig. 1 is a plan view of the stent of the present invention
  • Fig. 2 is an enlarged view of Fig. 1
  • Fig. 3 is an enlarged view showing a state of the stent of the present invention after expansion
  • Fig. 4 is a conceptual view of struts constituting a cell.
  • a stent 1 can form a generally tubular body of a plurality of ring units 4 formed of a plurality of cells 6 each and can expand in the radius directions from an inside of the tubular body.
  • the above plurality of cells 6 are connected to one another above and below, and a plurality of such cells 6 are arranged so as to surround a central axis C1 of the stent 1 forming the above tubular body, whereby one ring unit 4 is constituted.
  • a plurality of such ring units 4 are arranged in the axial direction of the stent 1 forming the above tubular body, and adjacent ring units 4 are connected to each other with a connector portion 5 at least in one portion each.
  • the above cell 6 means one component unit of a pattern constituting the surface of the stent 1, and the cell 6 includes all of embodiments each of which has at least one curved portion 12, specifically, a curved portion 12 having an acute angle X, and each of which is constituted of a generally linear portion 11 and a curved line portion 13 which are connected through the curved portion 12, as shown in Fig. 2.
  • the upper and lower portions of the cell are formed asymmetrically with regard to the center line C2, and are formed such that, when the above tubular body, that is, the stent is expanded so that the diameter ⁇ of the stent is, for example 2.5 mm, the curved portion 12 of the cell after expansion comes to have an angle ⁇ of 30° or greater as shown in Fig. 3.
  • the angle ⁇ of the curved portion 12 after expansion refers to an angle formed between the generally linear portion 11 from a point 0 on the curved portion 12 and that generally linear portion 15 of the curved-line portion 13 which is close to the point 0 side, as shown in Fig. 3.
  • each cell is constituted of the generally liner portion 11 and the curved-line portion 13 that are connected to each other through the curved portion 12, and the curved line portion 13 has two or more minor curved portions 14 having an obtuse angle Y each.
  • the radial sustaining force (to be also referred to as "radial force”) of the stent increases, as the generally liner portion 11, the curved portion 12 and the curved line portion 13 (to be also referred to as “generally S-shaped portion” hereinafter) having the minor curved portions 14, which form the cell 6, come to be closer to the perpendicular direction to the central axis C1 of the stent (or tubular body). That is, as the angle ⁇ of the curved portion 12 after expansion comes closer to 180° as shown in Fig. 3, the radial sustaining force increases.
  • the stent is formed such that when the above tubular body is expanded until it has a diameter ⁇ of 2.5 mm, preferably, 3.0 mm, the angle ⁇ of the above curved portion after expansion is at least 30°.
  • the above radial sustaining force refers to the rigidity of the stent in the circumferential direction (radius direction) of the stent and refers to the degree of easiness with which the stent is deformed in the circumferential direction (radius direction) of the stent.
  • a stent having a high radial force refers to a stent that is not easily deformed in the circumferential direction (radius direction) of the stent when it is inserted and placed deep in a blood vessel of an organism to be exerted an external pressure (outside pressure) from and through a blood vessel wall. That is, in view of the object of the stent, it is essential to create such a stent that can maintain its radial force at a high level.
  • the number of the cells 6 arranged in the radius direction is preferably 4 or more.
  • the number of the stents arranged is at least 6, preferably 6 to 12. (Number of cells in the axial direction and angle of curved portion after expansion)
  • the cells are desirably so disposed in number at least 3, preferably 4 to 8, per 10 mm in the axial direction of the stent, in order that the angle ⁇ of the curved portion 12 after expansion is at least 30°, preferably 45° to 140°, more preferably 45° to 120°, when the stent after expansion has an intended diameter (a specification diameter, e.g., ⁇ : 3.0 mm, ⁇ : 4.0 mm).
  • angle ⁇ after expansion in an intended diameter is effective for obtaining the sufficient radial sustaining force, which, however, undesirably makes the deformation of the curved portion 12 too large, thereby posing a problem with strength in stent and decreasing the total length of the stent due to expansion (to be referred to as "foreshortening" hereinafter), which causes a problem that exact positioning of the stent to the intended place becomes difficult when the placement of the stent is to be made.
  • the cell preferably has the following thickness and width. That is, when the angle ⁇ of the curved portion 12 of the above cell is defined as described above, the thickness of the above cell 6 (6A, 6B) [6A indicates a cell of a stent 1A (Figs. 6 and 7) and 6B indicates a cell of a stent 1B (Fig. 8 and 9). These reference numerals will be used in this sense hereinafter] (the thickness of a strut constituting the cell) is preferably 0.12 mm or less for preventing the thrombus formation.
  • the cell thickness is too small or less than 0.06 mm, X-ray imaging capability (contrast image formability) and the radial sustaining force decrease, so that the cell thickness is in the range of 0.06 to 0.12 mm, preferably 0.07 to 0.12 mm.
  • the higher radial sustaining force is more preferably obtained.
  • the width of the cell is too large, the metal area increases and risks of thrombus formation and restenosis increase.
  • the cell width in the stent of the present invention is in the range of 0.08 mm to 0.15 mm, preferably 0.08 mm to 0.12 mm.
  • the thickness and width of the cell 6 (6A, 6B) are defined as described above, and further, the ratio of the length 6L of the cell 6 (6A, 6B) in the axial direction of the stent and the length 5L of the connector portion 5 in the axial direction of the stent is determined to be in a specific range defined in the present invention as will be described later, whereby good X-ray imaging capability, the high radial sustaining force and the high flexibility can all be accomplished and maintained at the same time.
  • the strut form of the cell is preferably shaped so as to be asymmetric with regard to the center line C2 as shown in Fig. 4(b) rather than is formed so as to be symmetric as shown in Fig. 4(a). That is because of the following.
  • the relative length of the entire strut is larger (for example, a comparison of Fig. 4(a) and Fig. 4(b) inevitably shows 2a ⁇ c + d)), the expandability of the stent itself can be enhanced, and the more effective prevention of the foreshortening can be achieved.
  • the connector portion for cell-cell connection is constituted as follows.
  • the above connector portion 5 connecting the cells 6 and 6 in the stent 1 has at least 2 curved portions as shown in Fig. 2, and has a central generally linear portion 7, to both ends of which are connected curved portions 8 and 8. End portions of the above curved portion 8 are connected to the above cells 6 and 6 constituting different (adjacent) ring units 4 and 4 through connection portions 9 and 9.
  • the above connector portion 5 is asymmetrically connected to ends of the above cells 6 and 6 as shown in Fig. 2.
  • the total length (to be sometimes referred to as "5L'") of the generally liner portion 7 and the curved portions 8 and 8 is preferably at least 1 mm, since it is considered that the larger the length of the connector portion, the more improved the flexibility.
  • the S-shaped connector portion 5 itself becomes large in size, vertically adjacent connector portions 5 interfere with each other when the stent is mounted on a balloon catheter (the stent on a balloon catheter is sometimes decreased in diameter to some extent) or when the stent is made curved along a blood vessel while it passes through a curved portion of the blood vessel, which interference of connector portions causes impairment of the flexibility.
  • the total length (5L') of the entire connector portion is at least 1 mm, preferably 1 mm to 2 mm.
  • the R (radius) of an arc constituting the curved portion 8 is 0.05 mm or more, preferably 0.05 mm to 0.2 mm.
  • the thickness and width of the connector portion are preferably defined as follows.
  • the thickness of the above connector portion 5 [5A indicates the connector portion of a stent 1A (Figs. 6 and 7), and 5B indicates the connector portion of a stent 1B (Figs. 8 and 9).
  • These reference numerals will be used in this sense hereinafter] is as small as 0.12 mm or less for preventing the thrombus formation as described above.
  • the above thickness is too small or less than 0.06 mm, the X-ray imaging capability and the radial sustaining force come to decrease, so that the thickness of the connector portion is in the range of 0.06 to 0.12 mm, preferably 0.07 to 0.12 mm.
  • the width of the connector portion 5 (5A, 5B) is too large, the flexibility decreases. When it is too small, it involves risk of breaking when the stent is curved. Desirably, therefore, the above width is 0.1 mm or less, more preferably in the range of 0.04 to 0.10 mm, still more preferably 0.04 to 0.08 mm.
  • the width of the connector portion 5 (5A, 5B) is preferably smaller than that of the cell 6 (6A, 6B).
  • the length 5L is 50 to 100, preferably 55 to 80, more preferably 57 to 70, most preferably 58 to 65.
  • the length 5L' is 50 to 150, preferably 100 to 150.
  • the pattern of the stent of the present invention has the following features.
  • the cells 6 are asymmetrically arranged through the connector portions 5 with regard to the center line C2 in the axial direction of the stent, while the cells 6 are arranged in the same direction and at the same height in the axial direction of the stent. That is, the cells 6 positioned in the axial direction of the stent are arranged such that when the cells in an n-th column are moved to an (n+1)-th column in the axial direction of the stent, the cells in the n-th column lie overlapped on the cells in the (n+1)-th column.
  • the cells 6 are arranged in the same radius direction such that when the cells 6 in the same column (of the same ring unit) are shifted upward or downward, one cell overlaps on another cell. While the generally linear portion 11 of each cell is basically nearly horizontal (nearly in parallel) with regard to the center line C2, the generally linear portion 11 may tilt to some extent with an angle so long as the angle 6 of the curved portion 12 after expansion does not come to be less than 30° .
  • each of the connector portions 5 is also arranged through the cell 6 asymmetrically in the axial direction of the stent, and the connector portions 5 are arranged in the same direction with regard to the axial direction of the stent and at the same height. That is, the connector portions 5 positioned in the axial direction of the stent are arranged such that when the connector portions in an n-th column are moved to an (n+1)-th column in the axial direction of the stent, the connector portions in the n-th column lie over lapped on those in the (n+1)-th column. Further, the connector portions 5 are arranged in the same radius direction of the stent such that when the connector portions in the same column (of the same ring unit) are shifted upward or downward, one connector portion overlaps on another connector portion.
  • the cells 6 and the connector portions 5 in the axial direction of the stent are arranged such that the height of the cells 6 is not the same as, and differs from, the height of the connector portions 5.
  • the width of the strut constituting the cell is greater than that of the strut constituting the connector portion 5.
  • those factors such as the angle ⁇ of the curved portion 12 of the cell after expansion, the ratio of the length 6L of cell 6 in the axial direction of the stent and the length 5L of the connector portion 5 in the axial direction of the stent, the forms of the above mentioned connector portion and the cell and the layouts (pattern) of the connector portions 5 and the cells 6 in the radius and axial directions of the stent, are defined as described above.
  • these factors as were described, there is caused no overlapping of the cells 6 and the connector portions 5 each other in the radius direction of the stent, when the diameter of the stent 1 is decreased during delivery into a blood vessel as shown in Fig. 5.
  • the stent 1 is formed such that when the diameter of the stent 1 is decreased as shown in Fig. 5, the cell 6 and the connector portion 5 can be accommodated into a space S present between the cell 6 and the connector portion 5 in the radius direction of the stent as shown in Fig. 2.
  • Figs. 6 and 8 are plan views of other embodiments of the stent of the present invention.
  • Figs. 7 and 9 are respectively partial enlarged plan view of Figs. 6 and 8.
  • the stent 1A shown in Figs. 6 and 7 is basically the same as the stent 1 shown in Fig. 1 except for the following points. That is, the stent 1A differs in the following points.
  • the stent 1B shown in Figs. 8 and 9 differs from the stents 1 and 1A shown in Figs. 1, 6 and 7 in the following points. That is, the stent 1B basically differs in the following points.
  • the connector portions 5, 5A or 5B of the cells 6, 6A or 6B constituting each ring unit 4, 4A or 4B are continuously arranged without any omission or skipping in the radius direction of the stent 1, 1A or 1B.
  • the connector portions may be arranged by omitting or skipping every other one connector portion or omitting or skipping every other one or two connector portions to form spaces, thereby allowing the entire stent 1, 1A or 1B to become more flexible and it is expected that the more improved delivery of the stent to a branched blood vessel is made.
  • the material for constituting the stent 1, 1A or 1B of the present invention can be selected from known materials, and no special limitation is imposed thereon.
  • the stent 1, 1A or 1B is formed, for example, from a pipe made of stainless steel such as SUS316L, a shape-memory alloy such as a Ti-Ni alloy or a Cu-Al-Mn alloy, a Cu-Zn alloy, an Ni-Al alloy, titanium, a titanium alloy, tantalum, a tantalum alloy, platinum, a platinum alloy, tungsten or a tungsten alloy, for example, by a laser processing method.
  • the stent formed of the above metal may be surface-coated with a biocompatible polymer material such as polyurethane, polyvinyl pyrrolidone or polyvinyl alcohol or the like, with a material formed by immobilizing a physiologically active substance such as heparin or urokinase or the like to the above polymer material by chemical bonding, or with a mixture of the above polymer material and an antithrombotic drug such as argatroban, cilostazol or sarpogrelate hydrochloride or the like.
  • a biocompatible polymer material such as polyurethane, polyvinyl pyrrolidone or polyvinyl alcohol or the like
  • a material formed by immobilizing a physiologically active substance such as heparin or urokinase or the like to the above polymer material by chemical bonding
  • an antithrombotic drug such as argatroban, cilostazol or sarpogrelate hydrochloride or the like
  • a stent A(B) constituted of components 19 formed of a generally- ⁇ -shaped cell 17 and a generally-S-shaped connector portion 18 each as shown in Fig. 10
  • a stent A number of arranged components:8
  • a stent B number of arranged components:6
  • Stent A Number of arranged component 19 8 Width of strut of cells 17 0.12 mm Thickness of strut of cells 17 0.10 mm 1 ⁇ angle after expansion to 3 mm 60° stent B: Number of arranged component 19 6 Width of strut of cells 17 0.12 mm Thickness of strut of cells 17 0.10 mm 1 ⁇ angle after expansion to 3 mm 81°
  • each stent was expanded so as to have a diameter ⁇ of 3 mm and placed in a silicon tube placed in a chamber, then, pressure was applied into the chamber, and the stents were measured for changes in outer diameter.
  • Table 1 shows the measurement results. (Results of measurement of radial sustaining force)
  • Stent A Stent B Change in outer diameter during application of pressure at 0.02 MPa -0.07 mm -0.04 mm
  • the stent B having a larger angle (1 ⁇ ) after expansion showed a change of -0.04 mm in outer diameter (the outer diameter decreased by 0.04 mm), and the stent A showed a change of -0.07 mm in outer diameter (the outer diameter decreased by 0.07 mm), so it was confirmed that the stent B had a smaller change in outer diameter and had a greater radial sustaining force.
  • a stent shown in Fig. 1 was prepared, and the radial sustaining force thereof was compared with the counterparts of conventional stents 201 (Fig. 11) and 241 (Fig. 12). Further, the flexibility of the prepared stent was compared with that of the stent 201.
  • the ratio of the length 6L of the cell 6 in the axial direction of the stent and the length 5L of the connector portion 5 in the axial direction of the stent was determined such that on the basis that the length 6L of the cell 6 in the axial direction of the stent was taken as 100, the length 5L of the connector portion 5 in the axial direction of the stent was made 59.
  • the stent was evaluated for a radial sustaining force in the same manner as in Example 1, and it was evaluated for flexibility by a four-point bending method.
  • Table 2 shows the results of measurement of the radial sustaining force
  • Table 3 shows the results of measurement of the flexibility.
  • the stent 1 of the present invention shows a smaller change in outer diameter than any one of the stents 201 and 241, and as is clear from the results in Table 3, it has been confirmed that the stent 1 of the present invention has lower flexural strength than the stent 201.
  • the stent 1 of the present invention has both a high radial sustaining force and flexibility as described above.
  • a stent 1A shown in Fig. 6 (Fig. 7) and a stent 1B shown in Fig. 8 (Fig. 9) were measured and evaluated for radial sustaining forces and flexibility in the same manner as in Examples 1 and 2.
  • the ratio of the length 6AL, 6BL of the cell 6A, 6B in the axial direction of the stent and the length 5AL, 5BL of the connector portion 5A, 5B in the axial direction of the stent was determined and formed such that on the basis that the length 6AL, 6BL of the cell 6A, 6B in the axial direction of the stent was taken as 100, the length 5AL, 5BL of the connector portion 5A, 5B in the axial direction of the stent was 59.
  • Table 4 shows the results of measurement of the radial sustaining force
  • Table 5 shows the results of measurement of the flexibility.
  • the stent 1A and the stent 1B give substantially the same results as those of the stent 1.
  • Stent 1A Stent 1B Stent 201 Stent 241 Change in outer diameter during application of pressure at 0.02 MPa -0.033 mm -0.031 mm -0.05 mm -0.030 mm
  • Stent 1A Stent 1B Stent 201 Flexural strength 13.7 N-mm 14.3 N-mm 17.1 N ⁇ mm
  • the stents 1, 1A and 1B of the present invention were measured for foreshortening values when the stents were expanded until they had a diameter ⁇ of 3.0 mm.
  • each stent was measured for a length before the expansion (L1), and each stent was measured for a length after the expansion (L2) up to a diameter ⁇ of 3.0 mm.
  • a decrease ratio of the total length was calculated on the basis of the following equation and used as a foreshortening value.
  • Foreshortening value ((L1 - L2)/L1) x 100
  • Stent 1 Stent 1A Stent 1B Stent 201 Stent 241 Foreshortening value 1.5 % 1.5 % 3 % 5.6 % 5.6 %
  • the present inventors have further advanced the conception of the technical feature of the stent of the present invention for more accurately complying with higher demands in the high-tech health care, medical fields such as cardiac surgery, cerebral surgery, and the like.
  • an ultimate stent that is constituted with greatest accuracy and highly sophistication capable of satisfying any properties required as a stent when it is practically used in the above medical fields, as will be described below.
  • the basic technical conception of the highly-sophisticated stents 1, 1A and 1B of the present invention is to create a stent having following properties or characteristics.
  • the already discussed radial supporting force (rigidity in the circumferential direction (radius direction)) is to be maintained at a higher level. That is, even in a case where an external force is exerted on the circumference so as to depress and crush the stent, the stent is not to be easily deformed in the circumferential direction (radius direction).
  • the bending flexibility (easiness in expanding and contracting of the size in the axial direction of the stent) is to be maintained at a high level. That is, the stent is to have rigidity with which it is not easily deformed in the radius direction and is also to be easily extendable and contractible in the axial direction.
  • the stent is to be set such that the curved portion 12 (12A, 12B) of the cell 6 (6A, 6B) after expansion comes to have a large angle ⁇ (that is, 30° or more, preferably in the range of 45° to 140°).
  • the above number of the cells is too large, undesirably, it is impossible to design the angle ⁇ sufficiently large after expansion.
  • the number of the cells arranged is 6 or more, preferably 6 to 12.
  • the number of the cells 6 (6A, 6B) arranged in the axial direction of the stent should be large enough, for example, desirably, the number of the cells is at least 3, preferably 4 to 8, per 10 mm of the length of the stent.
  • the length 5L of the connector portion 5 (5A, 5B) in the axial direction of the stent is to be made sufficiently large, as large as is possible, or the total length 5L', the generally linear portion 7 and the curved portion 8 combined, is to be made long enough, as long as is possible.
  • the entire length 5L' thereof per unit surface area of the stent should be sufficiently large as possible.
  • the connector portions preferably have a form as will be described below.
  • the form of the connector portion is preferably a generally S-shaped one, and for maintaining the flexibility after expansion, preferably, the length 5L, 5L' of the connector portion 5 (5A, 5B) is such that the above generally S-shaped form can be maintained after expansion as shown in Fig. 3.
  • the length 5L, 5L' of the connector portion 5 For providing high bending flexibility to the stent, it is preferred to increase the length 5L, 5L' of the connector portion 5 (5A, 5B) as described above. At the same time, however, it is required to prevent the flare phenomenon after expansion of the stent or during delivery and also maintain the radial force at a high level. It is therefore necessary to configure a suitable length by taking into account the above facts and the relationship between the length 6L, etc., of the cell 6 (6A, 6B) in the axial (longitudinal) direction of the stent and the length 5L, 5L' of the connector portion 5 (5A, 5B).
  • the ratio of the length 5L (5AL, 5BL) of the above connector portion 5 (5A, 5B) in the axial direction of the stent and the length 6L (6AL, 6BL) of the cell 6 (6A, 6B) in the axial direction of the stent is configured such that when 6L (6AL, 6BL) is taken as 100, the 5L (5AL, 5BL) based thereon is 50 to 100, preferably 55 to 80, still more preferably 57 to 70, most preferably 58 to 65.
  • the length 5L, 5L' of the connector portion 5 is configured as large as possible, and the generally liner portions 7 and the curved portions 8 of the connector portions 8 are so arranged that they do not mutually interfere while the stent is being flexed or bent.
  • the ratio of the length 6L (6AL, 6BL) of the above cell 6 (6A, 6B) in the axial direction of the stent and the total length 5L', for example, of the generally liner portion 7 and the curved portions 8 of the connector portion 5 (5A, 5B) is preferably formed such that when 6L or the like is taken as 100, 5L' based thereon is 50 to 150, preferably 100 to 150.
  • the flare phenomenon after expansion of the stent or during delivery can be prevented, the radial sustaining force is able to be maintained at a high level and the stent per se can also be provided with flexibility, as are described already.
  • the connector portions 5 (5A, 5B) at the outermost ends (both ends) of the stent are formed to be softer as compared with the connector portions on the inward side of the stent.
  • the stent is provided with flexibility during insertion thereof into a blood vessel and can be easily inserted into a blood vessel.
  • the length 5L, 5L' at each end is to be made larger than that on the inward side, or the width thereof is to be made smaller than that on the inward side.
  • connector portions 5 (5A, 5B) on the first column on the left and the connector portions 5 (5A. 5B) on the first column on the right are to be formed so as to have a larger length 5L, 5L', or so as to have a smaller width, than the connector portions 5 (5A, 5B) arranged in columns between them.
  • the length 5L, 5L' and width of the connector portion 5 (5A, 5B) inward side of the stent are both taken as 100
  • the length 5L, 5L' of the connector portion 5 (5A, 5B) on each end of the stent is in the range of 120 to 200, preferably 140 to 180
  • the width thereof is in the range of 95 to 50, preferably 80 to 60, thereby the end portions of the stent are provided with preferable flexibility.
  • the cell 6 (6A, 6B) preferably has such a form that the stent can be easily mounted on a balloon catheter, in other words, such that struts on the entire stent surface do not interfere with one another when the stent is decreased in diameter and such that capable of maintaining the easily-expandable shape when expansion is made.
  • a form or configuration in which at least one generally linear portion 11 (11A) and the curved line portion 13 (13A) are connected through the curved portion 12 (12A) as shown in Fig. 2 or Fig. 7, or a form in which the generally linear portion 11B having an acute angle X with respect to the center line C2 in the axial direction of the stent 1B is connected to the generally linear portion 13B arranged nearly horizontally to the center line C2 in the axial direction of the stent 1 through the curved portion 12B as shown in Fig. 9.
  • the cell 6 can further have a longer strut as compared with a case where a liner-strut-conformation is made, so that the generally linear portion 11 (11A) and the curved line portion 13 (13A) constituting the cell 6 in the stent 1 (1A) can be made substantially equal to each other.
  • the area of the defined cell portion 6 can be effectively utilized, and the above cell form is also effective for preventing a decrease in length in the longitudinal direction (foreshortening) during expansion.
  • the struts of the cell 6 are preferably formed asymmetrically with respect to the center line C2 in the axial direction of the stent as shown in Fig. 4(b), and thereby, the relative length of the entire struts is made larger, the stent itself is provided with high expansion capability, and the more effective prevention of the foreshortening can be accomplished with this stent.
  • the stent of the present invention fully secures both high flexibility and high radial sustaining force (radial force (rigidity in the circumferential direction)), and further, preferably, it secures both high radial force and high bending flexibility (easiness in increasing and decreasing a size in the axial direction of the stent (expansion and contraction)), which causes an improvement in the vascular-dilation capability and the effective prevention of foreshortening and flare phenomenon are made.
  • the stent of the present invention thus can be used very suitably as a stent for securing a necessary intravascular or luminal region by dilating a stenosed portion, etc., of a blood vessel and the like.
EP20020785924 2001-10-16 2002-10-16 Endoprothèse vasculaire à flexibilité améliorée Expired - Lifetime EP1437157B1 (fr)

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JP2001318098 2001-10-16
JP2001318098 2001-10-16
JP2001322254A JP3605388B2 (ja) 2001-10-16 2001-10-19 ステント
JP2001322254 2001-10-19
PCT/JP2002/010705 WO2003039642A1 (fr) 2001-10-16 2002-10-16 Endoprothese vasculaire

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JP (1) JP3605388B2 (fr)
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US20050015136A1 (en) 2005-01-20
KR20040055785A (ko) 2004-06-26
EP1437157B1 (fr) 2012-06-06
ES2387083T3 (es) 2012-09-13
CN100558424C (zh) 2009-11-11
WO2003039642A1 (fr) 2003-05-15
KR100793125B1 (ko) 2008-01-10
CN1571686A (zh) 2005-01-26
EP1437157A4 (fr) 2009-02-11
US7985251B2 (en) 2011-07-26
JP2003190294A (ja) 2003-07-08
JP3605388B2 (ja) 2004-12-22

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